Systemic therapy for advanced appendiceal adenocarcinoma: An analysis from the NCCN oncology outcomes database for colorectal cancer

Mohamedtaki A. Tejani*, Anna Ter Veer, Dana Milne, Rebecca Ottesen, Tanios Bekaii-Saab, Al B Benson III, Deborah Schrag, Stephen Shibata, John Skibber, Martin Weiser, Neal Wilkinson, Steven J. Cohen

*Corresponding author for this work

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Appendiceal malignancies are rare and represent 1% of intestinal tumors in the United States. The role and efficacy of modern systemic therapy in advanced appendiceal adenocarcinoma has not been established. This study analyzed patients with recurrent or metastatic appendiceal adenocarcinoma in the database for Colorectal Cancer (CRC; 2005-2012). This database tracks longitudinal care for patients treated at 8 specialty centers across the Unites States. Study objectives were to describe and evaluate the efficacy of systemic therapy and investigate relationships with clinicopathologic features. Cox regression analysis was performed to identify predictors of progression-free survival (PFS) and overall survival (OS). Of 248 patients with advanced appendiceal carcinoma, 112 (45%) received systemic therapy for measurable disease and are the focus of this report. The most common chemotherapy regimens included FOLFOX with or without bevacizumab (n=39 and n=37, respectively), FOLFIRI (n=15), and single-agent fluoropyrimidine (n=10). Among 99 patients evaluable for best response, 39 experienced a response (response rate [RR], 39%) and 36 (36%) had stable disease. The median PFS was 1.2 years (95% CI, 1.0-1.8) and median OS was 2.1 years (95% CI, 1.6-2.3). Patients with nonmucinous histology or high-grade tumors and those who underwent nondebulking surgery had worse PFS and OS. Treatment of advanced appendiceal adenocarcinoma at NCCN Member Institutions commonly incorporates agents used for CRC. RR, PFS, and OS are comparable to those achieved in the treatment of metastatic CRC. Poor prognostic factors include nonmucinous histology or high-grade tumors and history of nondebulking surgery.

Original languageEnglish (US)
Pages (from-to)1123-1130
Number of pages8
JournalJNCCN Journal of the National Comprehensive Cancer Network
Volume12
Issue number8
DOIs
StatePublished - Aug 1 2014

Fingerprint

Colorectal Neoplasms
Adenocarcinoma
Disease-Free Survival
Databases
Survival
Neoplasms
Histology
Therapeutics
Patient Care
Regression Analysis
Carcinoma
Drug Therapy

ASJC Scopus subject areas

  • Oncology

Cite this

Tejani, Mohamedtaki A. ; Veer, Anna Ter ; Milne, Dana ; Ottesen, Rebecca ; Bekaii-Saab, Tanios ; Benson III, Al B ; Schrag, Deborah ; Shibata, Stephen ; Skibber, John ; Weiser, Martin ; Wilkinson, Neal ; Cohen, Steven J. / Systemic therapy for advanced appendiceal adenocarcinoma : An analysis from the NCCN oncology outcomes database for colorectal cancer. In: JNCCN Journal of the National Comprehensive Cancer Network. 2014 ; Vol. 12, No. 8. pp. 1123-1130.
@article{c73915c26a0b4c46b510a2fc4413b6e0,
title = "Systemic therapy for advanced appendiceal adenocarcinoma: An analysis from the NCCN oncology outcomes database for colorectal cancer",
abstract = "Appendiceal malignancies are rare and represent 1{\%} of intestinal tumors in the United States. The role and efficacy of modern systemic therapy in advanced appendiceal adenocarcinoma has not been established. This study analyzed patients with recurrent or metastatic appendiceal adenocarcinoma in the database for Colorectal Cancer (CRC; 2005-2012). This database tracks longitudinal care for patients treated at 8 specialty centers across the Unites States. Study objectives were to describe and evaluate the efficacy of systemic therapy and investigate relationships with clinicopathologic features. Cox regression analysis was performed to identify predictors of progression-free survival (PFS) and overall survival (OS). Of 248 patients with advanced appendiceal carcinoma, 112 (45{\%}) received systemic therapy for measurable disease and are the focus of this report. The most common chemotherapy regimens included FOLFOX with or without bevacizumab (n=39 and n=37, respectively), FOLFIRI (n=15), and single-agent fluoropyrimidine (n=10). Among 99 patients evaluable for best response, 39 experienced a response (response rate [RR], 39{\%}) and 36 (36{\%}) had stable disease. The median PFS was 1.2 years (95{\%} CI, 1.0-1.8) and median OS was 2.1 years (95{\%} CI, 1.6-2.3). Patients with nonmucinous histology or high-grade tumors and those who underwent nondebulking surgery had worse PFS and OS. Treatment of advanced appendiceal adenocarcinoma at NCCN Member Institutions commonly incorporates agents used for CRC. RR, PFS, and OS are comparable to those achieved in the treatment of metastatic CRC. Poor prognostic factors include nonmucinous histology or high-grade tumors and history of nondebulking surgery.",
author = "Tejani, {Mohamedtaki A.} and Veer, {Anna Ter} and Dana Milne and Rebecca Ottesen and Tanios Bekaii-Saab and {Benson III}, {Al B} and Deborah Schrag and Stephen Shibata and John Skibber and Martin Weiser and Neal Wilkinson and Cohen, {Steven J.}",
year = "2014",
month = "8",
day = "1",
doi = "10.6004/jnccn.2014.0109",
language = "English (US)",
volume = "12",
pages = "1123--1130",
journal = "Journal of the National Comprehensive Cancer Network : JNCCN",
issn = "1540-1405",
publisher = "Cold Spring Publishing LLC",
number = "8",

}

Tejani, MA, Veer, AT, Milne, D, Ottesen, R, Bekaii-Saab, T, Benson III, AB, Schrag, D, Shibata, S, Skibber, J, Weiser, M, Wilkinson, N & Cohen, SJ 2014, 'Systemic therapy for advanced appendiceal adenocarcinoma: An analysis from the NCCN oncology outcomes database for colorectal cancer', JNCCN Journal of the National Comprehensive Cancer Network, vol. 12, no. 8, pp. 1123-1130. https://doi.org/10.6004/jnccn.2014.0109

Systemic therapy for advanced appendiceal adenocarcinoma : An analysis from the NCCN oncology outcomes database for colorectal cancer. / Tejani, Mohamedtaki A.; Veer, Anna Ter; Milne, Dana; Ottesen, Rebecca; Bekaii-Saab, Tanios; Benson III, Al B; Schrag, Deborah; Shibata, Stephen; Skibber, John; Weiser, Martin; Wilkinson, Neal; Cohen, Steven J.

In: JNCCN Journal of the National Comprehensive Cancer Network, Vol. 12, No. 8, 01.08.2014, p. 1123-1130.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Systemic therapy for advanced appendiceal adenocarcinoma

T2 - An analysis from the NCCN oncology outcomes database for colorectal cancer

AU - Tejani, Mohamedtaki A.

AU - Veer, Anna Ter

AU - Milne, Dana

AU - Ottesen, Rebecca

AU - Bekaii-Saab, Tanios

AU - Benson III, Al B

AU - Schrag, Deborah

AU - Shibata, Stephen

AU - Skibber, John

AU - Weiser, Martin

AU - Wilkinson, Neal

AU - Cohen, Steven J.

PY - 2014/8/1

Y1 - 2014/8/1

N2 - Appendiceal malignancies are rare and represent 1% of intestinal tumors in the United States. The role and efficacy of modern systemic therapy in advanced appendiceal adenocarcinoma has not been established. This study analyzed patients with recurrent or metastatic appendiceal adenocarcinoma in the database for Colorectal Cancer (CRC; 2005-2012). This database tracks longitudinal care for patients treated at 8 specialty centers across the Unites States. Study objectives were to describe and evaluate the efficacy of systemic therapy and investigate relationships with clinicopathologic features. Cox regression analysis was performed to identify predictors of progression-free survival (PFS) and overall survival (OS). Of 248 patients with advanced appendiceal carcinoma, 112 (45%) received systemic therapy for measurable disease and are the focus of this report. The most common chemotherapy regimens included FOLFOX with or without bevacizumab (n=39 and n=37, respectively), FOLFIRI (n=15), and single-agent fluoropyrimidine (n=10). Among 99 patients evaluable for best response, 39 experienced a response (response rate [RR], 39%) and 36 (36%) had stable disease. The median PFS was 1.2 years (95% CI, 1.0-1.8) and median OS was 2.1 years (95% CI, 1.6-2.3). Patients with nonmucinous histology or high-grade tumors and those who underwent nondebulking surgery had worse PFS and OS. Treatment of advanced appendiceal adenocarcinoma at NCCN Member Institutions commonly incorporates agents used for CRC. RR, PFS, and OS are comparable to those achieved in the treatment of metastatic CRC. Poor prognostic factors include nonmucinous histology or high-grade tumors and history of nondebulking surgery.

AB - Appendiceal malignancies are rare and represent 1% of intestinal tumors in the United States. The role and efficacy of modern systemic therapy in advanced appendiceal adenocarcinoma has not been established. This study analyzed patients with recurrent or metastatic appendiceal adenocarcinoma in the database for Colorectal Cancer (CRC; 2005-2012). This database tracks longitudinal care for patients treated at 8 specialty centers across the Unites States. Study objectives were to describe and evaluate the efficacy of systemic therapy and investigate relationships with clinicopathologic features. Cox regression analysis was performed to identify predictors of progression-free survival (PFS) and overall survival (OS). Of 248 patients with advanced appendiceal carcinoma, 112 (45%) received systemic therapy for measurable disease and are the focus of this report. The most common chemotherapy regimens included FOLFOX with or without bevacizumab (n=39 and n=37, respectively), FOLFIRI (n=15), and single-agent fluoropyrimidine (n=10). Among 99 patients evaluable for best response, 39 experienced a response (response rate [RR], 39%) and 36 (36%) had stable disease. The median PFS was 1.2 years (95% CI, 1.0-1.8) and median OS was 2.1 years (95% CI, 1.6-2.3). Patients with nonmucinous histology or high-grade tumors and those who underwent nondebulking surgery had worse PFS and OS. Treatment of advanced appendiceal adenocarcinoma at NCCN Member Institutions commonly incorporates agents used for CRC. RR, PFS, and OS are comparable to those achieved in the treatment of metastatic CRC. Poor prognostic factors include nonmucinous histology or high-grade tumors and history of nondebulking surgery.

UR - http://www.scopus.com/inward/record.url?scp=84906234286&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906234286&partnerID=8YFLogxK

U2 - 10.6004/jnccn.2014.0109

DO - 10.6004/jnccn.2014.0109

M3 - Article

C2 - 25099444

AN - SCOPUS:84906234286

VL - 12

SP - 1123

EP - 1130

JO - Journal of the National Comprehensive Cancer Network : JNCCN

JF - Journal of the National Comprehensive Cancer Network : JNCCN

SN - 1540-1405

IS - 8

ER -